PMID- 31143778
OWN - NLM
STAT- MEDLINE
DCOM- 20191120
LR  - 20200225
IS  - 2314-6141 (Electronic)
IS  - 2314-6133 (Print)
VI  - 2019
DP  - 2019
TI  - Kyphoplasty of Osteoporotic Fractured Vertebrae: A Finite Element Analysis about 
      Two Types of Cement.
PG  - 9232813
LID - 10.1155/2019/9232813 [doi]
LID - 9232813
AB  - If conservative treatment of osteoporotic vertebral compression fractures fails, 
      vertebro- or kyphoplasty is indicated. Usually, polymethylmethacrylate cement 
      (PMMA) is applied coming along with many disadvantageous features. Aluminum-free 
      glass-polyalkenoate cement (GPC) appears to be a benefit alternative material. 
      This study aimed at comparing the mean stress values in human vertebrae after 
      kyphoplasty with PMMA and GPC (IlluminOss) at hand of a finite element analysis. 
      Three models were created performing kyphoplasty using PMMA or IlluminOss, 
      respectively, at two native, human lumbar vertebrae (L4) while one remains 
      intact. Finite element analysis was performed using CT-scans of every vertebra. 
      Moreover the PMMA-treated vertebra was used as a model as analyses were executed 
      using material data of PMMA and of GPC. The unimpaired, spongious bone showed 
      potentials of 0.25 MPa maximally. After augmentation stress levels showed 
      fivefold increase, rising from externally to internally, revealing stress peaks 
      at the ventral border of the spinal canal. At central areas of cement 1 MPa is 
      measured in both types of cement. Around these central areas the von Mises stress 
      decreased about 25-50% (0.5-0.75 MPa). If workload of 500 N was applied, the 
      stress appeared to be more centralized at the IlluminOss-model, similar to the 
      unimpaired. Considering the endplates the GPC model also closely resembles the 
      unimpaired. Comparing the PMMA-treated vertebral body and the GPC-simulation, 
      there is an obvious difference. While the PMMA-treated model showed a central 
      stress peak of 5 MPa, the GPC-simulation of the same vertebral body presents 
      lower stress of 1.2-2.5 MPa. Finite element analysis showed that IlluminOss 
      (GPC), used in kyphoplasty of vertebral bodies, creates lower level stress and 
      strain compared to standardly used PMMA, leading to lower stress concentrations 
      on the cranial and caudal vertebral surface especially. GPC appears to own 
      advantageous biological and clinical relevant features.
FAU - Meyer, Carolin
AU  - Meyer C
AUID- ORCID: 0000-0002-1498-4827
AD  - University Hospital of Cologne, Department of Orthopedics and Trauma Surgery, 
      Kerpener Strasse 62, 50937 Cologne, Germany.
FAU - van Gaalen, Kerstin
AU  - van Gaalen K
AD  - College of Biomedical Engineering, RWTH Aachen, Templergraben 55, 52056 Aachen, 
      Germany.
FAU - Leschinger, Tim
AU  - Leschinger T
AUID- ORCID: 0000-0003-1319-6949
AD  - University Hospital of Cologne, Department of Orthopedics and Trauma Surgery, 
      Kerpener Strasse 62, 50937 Cologne, Germany.
FAU - Scheyerer, Max J
AU  - Scheyerer MJ
AUID- ORCID: 0000-0003-1392-3990
AD  - University Hospital of Cologne, Department of Orthopedics and Trauma Surgery, 
      Kerpener Strasse 62, 50937 Cologne, Germany.
FAU - Neiss, Wolfram F
AU  - Neiss WF
AD  - University of Cologne, Institute of Anatomy, Joseph-Stelzmann Str. 9, 50931 
      Cologne, Germany.
FAU - Staat, Manfred
AU  - Staat M
AUID- ORCID: 0000-0003-4363-6570
AD  - University of Applied Science, FH Aachen, Heinrich-Mussmann Str. 1, 52428 Julich, 
      Germany.
FAU - Muller, Lars P
AU  - Muller LP
AD  - University Hospital of Cologne, Department of Orthopedics and Trauma Surgery, 
      Kerpener Strasse 62, 50937 Cologne, Germany.
FAU - Wegmann, Kilian
AU  - Wegmann K
AD  - University Hospital of Cologne, Department of Orthopedics and Trauma Surgery, 
      Kerpener Strasse 62, 50937 Cologne, Germany.
LA  - eng
PT  - Journal Article
DEP - 20190422
PL  - United States
TA  - Biomed Res Int
JT  - BioMed research international
JID - 101600173
RN  - 0 (Bone Cements)
RN  - 0 (Glass Ionomer Cements)
RN  - 9011-14-7 (Polymethyl Methacrylate)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Cements/*therapeutic use
MH  - Cancellous Bone/pathology
MH  - Cortical Bone/surgery
MH  - Female
MH  - *Finite Element Analysis
MH  - Glass Ionomer Cements/chemistry
MH  - Humans
MH  - *Kyphoplasty
MH  - Male
MH  - Osteoporotic Fractures/*surgery
MH  - Polymethyl Methacrylate/chemistry
MH  - Spinal Fractures/*surgery
MH  - Stress, Mechanical
PMC - PMC6501275
EDAT- 2019/05/31 06:00
MHDA- 2019/11/21 06:00
PMCR- 2019/04/22
CRDT- 2019/05/31 06:00
PHST- 2019/01/13 00:00 [received]
PHST- 2019/04/09 00:00 [accepted]
PHST- 2019/05/31 06:00 [entrez]
PHST- 2019/05/31 06:00 [pubmed]
PHST- 2019/11/21 06:00 [medline]
PHST- 2019/04/22 00:00 [pmc-release]
AID - 10.1155/2019/9232813 [doi]
PST - epublish
SO  - Biomed Res Int. 2019 Apr 22;2019:9232813. doi: 10.1155/2019/9232813. eCollection 
      2019.